Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 10/28/2024
    TIME: 2315
    RECEIVED BY:
    CONTROL#:
    Cal OES - 24-6091
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
SolvOne
1.b. PERSON REPORTING SPILL (If different from above):
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
2. SUBSTANCE TYPE:
2. a. SUBSTANCE:b.QTY:>=<Amount Measurec. TYPE:d. OTHER:e. PIPELINEf. VESSEL
>= 300 Tons
1. Unleaded Petroleum=19 Gal(s)PETROLEUMNoNo
2. = NoNo
3. = NoNo
g. DESCRIPTION: Reporting party states customer had a hole in gas tank while filling up at the pump. This resulted in a spill of 19 gallons of fuel onto pavement. No storm drains, waterways or soil was impacted. Employees laid down booms and pads to contain the spill. Fire department used additional absorbent for the spill. Station was closed for the clean-up process. The time of re-opening is unknown at this time. Business currently does not have anyone to complete site clean-up.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedNoNoneNo
l. MARITIME VESSEL
No
m. KNOWN IMPACT
Other
Reason for Other: Business is closed during clean-up
3. a. INCIDENT LOCATION: 1010 East Cypress Ave/ Safeway Gas Station
b. CITY:c. COUNTY: d. ZIP:
Redding
Shasta CountySHASTA COUNTY AQMD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
10/28/20242225 Merchant/Business, Service Station Mechanical
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoUnknown
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
Fire Dept.
d. ADMIN. AGENCY: Shasta County Environmental Healthe. SEC. AGENCY:
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
Cal GEM:
RWQCB Unit:

5A
Cal OES Region:
AA/CUPA, DTSC, RWQCB, US EPA, USFWS, Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 24-6091 *********

Created by: Warning Center on: 10/28/2024 11:15:10 PM Last Modified by: Warning Center on: 10/28/2024 11:28:51 PM